The events of September 11, 2001 dramatically raised national awareness concerning the need for disaster preparedness while the anthrax attacks occurring shortly thereafter demonstrated our vulnerability to bioterrorist (BT) attack. Increasingly frequent naturally occurring epidemics such as the recent outbreak of Severe Adult Respiratory Syndrome (SARS) has further reinforced awareness of the need to rapidly improve health care system critical event preparedness. Indeed, the need for rapid and job-specific training of all healthcare workers is now widely recognized and even mandated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Unfortunately, it remains very difficult for institutions to comply as the required tools for rapid, inexpensive and task-appropriate training do not currently exist. As there is currently no accepted standard for healthcare worker training in BT and disaster response, each institution must either use their own limited resources to create educational programs or borrow from the few existing courses, none of which have been objectively tested to determine their educational value. We therefore propose to develop and apply evidence-based expert consensus process techniques to create standard, "best practice" educational content for training of community clinicians in bioterrorism and disaster response. This content will be used to develop two distinct modular training courses, one using traditional teaching techniques and the other using Web-based technology; each suitable for job-targeted training of the wide range of professional levels of community clinicians and hospital staff. We then propose to directly measure and compare the educational effectiveness and costs of the two course formats when applied to staff from a variety of healthcare settings in a prospective, randomized controlled cohort study. Finally, a structured process will be used to incorporate feedback concerning both courses resulting in a fully tested and optimized "blended learning" product as well as model processes for course development, training, tracking and evaluation; each ready for nationwide dissemination.